A Rare Case of Primary Breast Osteosarcoma Evaluated with Multiple Modalities

Tomoyuki Fujioka; Mio Mori; Iichiroh Onishi; Yuka Yashima; Emi Yamaga; Jun Oyama; Kota Yokoyama; Kazunori Kubota; Goshi Oda; Tsuyoshi Nakagawa; Ukihide Tateishi

doi:10.3390/diagnostics11071170

A Rare Case of Primary Breast Osteosarcoma Evaluated with Multiple Modalities

Diagnostics (Basel). 2021 Jun 28;11(7):1170. doi: 10.3390/diagnostics11071170.

Authors

Affiliations

¹ Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
² Department of Diagnostic Pathology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
³ Department of Radiology, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan.
⁴ Department of Surgery, Breast Surgery, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.

Abstract

Primary breast osteosarcoma (PBO) is very rare. This report presents a case of POB that was evaluated by multiple modalities. A woman in her 70s presented with a mass of increasing size in her right breast. A mammogram and an ultrasound visualized a lobulated mass containing coarse calcification in the right breast. Magnetic resonance imaging showed a strong enhancement effect and high signal on diffusion-weighted imaging. Further imaging on 18F-fluorodeoxyglucose positron-emission tomography and computed tomography exhibited a high uptake. A right total mastectomy was performed. Histologic examination revealed abundant periosteal formation, areas of calcification and moderately pleomorphic oval to spindle-shaped stromal cells, leading to the diagnosis of PBO. The presence of calcified breast tumors exhibiting aggressive growth indicates that PBO should be added to the differential diagnosis.

Keywords: 18F-fluorodeoxyglucose positron-emission tomography; magnetic resonance imaging; mammography; primary breast osteosarcoma; ultrasound.